PRIMAQUINE FOR PROPHYLAXIS AGAINST MALARIA AMONG NONIMMUNE TRANSMIGRANTS IN IRIAN-JAYA, INDONESIA

A comparison of primaquine versus chloroquine for prophylaxis among no nimmune transmigrants from Java and Ball in the hyperendemic Arso regi on of Irian Jaya, Indonesia was conducted. Forty-five subjects receive d 0.5 mg of primaquine base/kg of body weight every other day, and 54 people in the same village received weekly 5 mg of chloroquine base/kg for 16-19 weeks beginning in December 1992. Plasmodium falciparum acc ounted for 18 of 30 infections with chloroquine, and four of five infe ctions among subjects receiving primaquine. Plasmodium vivax was found in 12 people taking chloroquine but in just one person taking primaqu ine. The risk of malaria among people taking chloroquine relative to t hat among subjects taking primaquine was 3.96 (P = 0.014) for P. falci parum and 10.56 (P = 0.012) for P. vivax. Primaquine was better tolera ted than chloroquine. The minimal protective efficacy for primaquine p rophylaxis was 74% against P. falciparum and 90% against P. vivax amon g nonimmune children and adults living in Irian Jaya. These findings r equire confirmation with randomized, double-blinded, and placebo-contr olled trials.